Annals for Hospitalists Inpatient Notes - Clinical Pearls—Updates on <i>Clostridioides difficile</i> Infection for Hospitalists
Authors: Daniel Marino, Colleen R. Kelly
Journal: Annals of Internal Medicine (2022)

Web ExclusivesSeptember 2022Annals for Hospitalists Inpatient Notes - Clinical Pearls—Updates on Clostridioides difficile Infection for HospitalistsDaniel Marino, MD, MBA and Colleen R. Kelly, MDDaniel Marino, MD, MBADepartment of Internal Medicine, Brown University, Providence, Rhode Island (D.M.)Search for more papers by this author and Colleen R. Kelly, MDDivision of Gastroenterology, Brown University, Providence, Rhode Island (C.R.K.).Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M22-2266 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail A 72-year-old woman with hypertension and recurrent urinary tract infections presents with 3 days of profuse, watery diarrhea associated with severe urgency and fecal incontinence. She recently completed a course of levofloxacin for pyelonephritis. On examination, the patient is afebrile and her abdomen is nondistended and mildly tender to palpation with normal bowel sounds. Laboratory testing reveals a leukocyte count of 16.2 × 109 cells/L and creatinine level of 150.28 μmol/L (1.7 mg/dL). Clostridioides difficile/ infection (CDI) is suspected, and stool studies are ordered.Clinical Pearls1. For best diagnostic accuracy, patients with unexplained, new-onset diarrhea (≥3 unformed stools in ...References1. Kelly CR, Fischer M, Allegretti JR, et al. ACG clinical guidelines: prevention, diagnosis, and treatment of Clostridioides difficile infections. Am J Gastroenterol. 2021;116:1124-47. Erratum in:. Am J Gastroenterol. 2022;117:358. [PMID: 34003176] doi:10.14309/ajg.0000000000001278 CrossrefMedlineGoogle Scholar2. McDonald LC, Gerding DN, Johnson S, et al. Clinical practice guidelines for Clostridium difficile infection in adults and children: 2017 update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clin Infect Dis. 2018;66:e1-e48. [PMID: 29462280] doi:10.1093/cid/cix1085 CrossrefMedlineGoogle Scholar3. Johnson S, Lavergne V, Skinner AM, et al. Clinical practice guideline by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA): 2021 focused update guidelines on management of Clostridioides difficile infection in adults. Clin Infect Dis. 2021;73:e1029-44. [PMID: 34164674] doi:10.1093/cid/ciab549 CrossrefMedlineGoogle Scholar4. Wilcox MH, Gerding DN, Poxton IR, et al; MODIFY I and MODIFY II Investigators. Bezlotoxumab for prevention of recurrent Clostridium difficile infection. N Engl J Med. 2017;376:305-17. [PMID: 28121498] doi:10.1056/NEJMoa1602615 CrossrefMedlineGoogle Scholar5. Quraishi MN, Widlak M, Bhala N, et al. Systematic review with meta-analysis: the efficacy of faecal microbiota transplantation for the treatment of recurrent and refractory Clostridium difficile infection. Aliment Pharmacol Ther. 2017;46:479-93. [PMID: 28707337] doi:10.1111/apt.14201 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Daniel Marino, MD, MBA; Colleen R. Kelly, MDAffiliations: Department of Internal Medicine, Brown University, Providence, Rhode Island (D.M.)Division of Gastroenterology, Brown University, Providence, Rhode Island (C.R.K.).Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M22-2266.Corresponding Author: Daniel Marino, MD, MBA, Department of Internal Medicine, 593 Eddy Street, Providence, RI 02903; e-mail, [email protected]org. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAnnals for Hospitalists - September 2022 David H. Wesorick Metrics September 2022Volume 175, Issue 9Page: HO2-HO3KeywordsAntibioticsDiarrheaFecal microbiota transplant ePublished: 20 September 2022 Issue Published: September 2022 Copyright & PermissionsCopyright © 2022 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...